STANLEY EDWARDS (PH.D.) – Clinical Psychologist, NPI 1568459980

STANLEY EDWARDS (PH.D.) is a healthcare provider. based in Bowling green, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 6096 (OH). The NPI Number for STANLEY EDWARDS (PH.D.) is 1568459980

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
STANLEY EDWARDS (PH.D.)
NPI
1568459980
Phone
(419) 352-7588
Address
1045 KLOTZ RD
Enumeration Date
30 September 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4193811881
Graduation Year
2001 (25 years ago)
PAC ID
4082610480
Group Practice PAC ID
0143133181
Professional Enrollment ID
I20061006000518
Address ID
OH436142701TO930XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for STANLEY EDWARDS (PH.D.)

  • 1045, Klotz Road, Meadowvale, Bowling Green, Wood County, Ohio, 43402, United States

    P.O. BOX 738

    BOWLING GREEN, OH 434024820

    Phone: (419) 352-7588

    Fax: (419) 354-4977

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-10-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061006000518IClinical PsychologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43402)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143133181View full group profile
NameSpecialtyState
-OH
Clinical PsychologistOH
P S Y C H I A T R YOH
Certified Clinical Nurse Specialist (Cns)OH
Clinical PsychologistOH
Family PracticeOH
-OH
-OH
-MD
-OH

Reviews

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Frequently asked questions

Is STANLEY EDWARDS (PH.D.) listed with a National Provider Identifier?
Yes — STANLEY EDWARDS (PH.D.) has NPI 1568459980 on file in the registry.
Active or inactive — what applies to STANLEY EDWARDS (PH.D.)?
You should see STANLEY EDWARDS (PH.D.) as active in CMS-hosted NPPES data.
How would a patient describe STANLEY EDWARDS (PH.D.)'s focus?
For STANLEY EDWARDS (PH.D.), the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for STANLEY EDWARDS (PH.D.)?
Travel planning: use Bowling Green, Ohio as the reference point for STANLEY EDWARDS (PH.D.), then confirm.
When was this NPI issued?
Enumeration for STANLEY EDWARDS (PH.D.) is noted as September 30, 2005 where the registry provides it.

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